Home Care of the Heart Failure Patient

This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian.

While heart (cardiac) failure is usually not curable, with proper management many pets can continue to enjoy a good quality of life. You will play an important role in the management of your pet’s heart condition in several ways. Although the following guidelines and suggestions may seem overwhelming at first, most can easily be incorporated into your daily routine.

Observation

General observation:

Appetite, water intake, attitude, and general activity should be monitored frequently. Changes in these parameters may indicate problems, including medication side effects, worsening heart failure, another cardiac complication, or a non-cardiac problem.

Respiratory rate:

Observe your pet’s normal breathing (respiratory) rate during periods of rest or sleep. Without disturbing your pet, count the number of breaths he/she takes in 15 seconds and multiply that number by 4 to get the breathing rate per minute. Usually this is less than 30 breaths/minute. A persistent increase of 20% or more over 2 to 3 days may indicate the accumulating of fluid in the lungs (pulmonary edema).

Heart rate:

Your veterinarian may also suggest monitoring your pet’s resting heart (pulse) rate. A persistent increase of 20% or more may also signal a worsening heart failure.

It is common to use several medications simultaneously in the treatment of chronic heart failure. Understanding the purpose and possible side effects of each medication is helpful. Be sure to ask your veterinarian if you don’t know the reason for using each medicine and what to watch for. Because heart diseases do progress and complicating factors can arise, it is usually necessary to make medication adjustments over time.

Administration

Conscientious administration of prescribed medications as directed is important. This includes careful dividing of pills or measuring of liquids when indicated, giving medications at the prescribed dose and time intervals, and requesting refills before running out of medications. Posting a medication schedule on the refrigerator and/or putting the day’s (or week’s) pills in a labeled and compartmentalized pillbox ahead of time can help keep you organized. Also, recording when a dose is given also helps assure that your pet receives all medications as scheduled; especially if more than one person is involved with the therapy.

Re-evaluations

Your veterinarian will want to review all the medications your pet is receiving (including non-cardiac ones) at each recheck. This includes each drug’s name, pill size (mg) or liquid concentration (mg/ml), dose being given, and times of administration. For each of your pet’s recheck appointments, either bring a current list of all medications, pill sizes, dosages, etc. or all medication containers currently being used. Making a logbook of daily medications given can be helpful, especially if your pet is experiencing recurrent signs of heart failure or other complications.

Be sure to let your veterinarian know if you suspect adverse effects form any medication. Periodically, he/she will also do blood tests to monitor your pet’s kidney function and electrolyte (e.g. potassium, sodium) levels as well as other tests as indicated.

Diet

Diets reduced in salt (sodium chloride) are usually recommended for patients with heart failure because of the tendency to retain salt and water with this condition. Generally, many supermarket and specialty brands of pet food have relatively high salt levels. Homemade low salt diets can be made if necessary, but commercially available reduced sodium diets are recommended whenever possible because they are nutritionally balanced as well as convenient. Treats and "people food" that are high in salt should be avoided. These include processed meats and cheeses, chips, pretzels, etc.

Moderate salt restriction

Most animals with heart failure do well with moderate dietary salt restriction (containing about 0.2 to 0.25% sodium on a dry matter basis for dogs and 0.25 to 0.33% for cats). Science Diet Senior, Hills K/D and Purina CNM NF-Formula are examples.

Greater Salt Restriction

More stringent sodium restriction is sometimes helpful in advanced heart failure. Hill’s H/D, Waltham low sodium, Purina CNM Canine CV-Formula, Hill’s Healthblend Canine Geriatric, and Purina CNM Feline NF-Formula are examples. High levels of sodium in drinking water may be of concern in some pets whose heart failure is hard to control; distilled or low sodium bottled water can be used in this situation.

Exercise

Decreased exercise tolerance and activity level may be one of the first signs of heart failure. While strenuous exercise can provoke respiratory symptoms, regular mild to moderate exercise is thought to be beneficial for animals with compensated heart failure. Encourage an activity level that does not cause excessive panting, shortness of breath, or weakness. Your pet should not be forced to continue exercise with he/she tires.

Contact your veterinarian if your pet experiences collapse or sudden weakness during activity or a dramatic decrease in overall exercise ability. Animals with signs of severe or decompensated heart failure should not be exercised.